:

Modernize Medicaid to better support people with disabilities

THE HILL Congress Blog  June 30, 2011
By Sen. Tom Harkin (D-Iowa) and Rep. Cathy McMorris Rodgers (R-Wash.) – 06/30/11 01:09 PM ET

 

This month marks the 12th anniversary of the Supreme Court’s landmark decision in Olmstead V. L.C., ruling that the needless institutionalization of people with disabilities is illegal discrimination.  Despite that decision, misguided Medicaid rules continue to force millions of people with disabilities to remain in nursing homes, against their wishes and at a much greater cost to taxpayers than many home and community-based alternatives.  

Today, as we seek ways to reduce budget deficits, we must seize on the opportunity to make our Medicaid dollars go farther while finally giving millions of individuals with disabilities one of the most fundamental of rights: the choice to live independently.  Read the rest of this entry »

Governor Brown Signs Main Budget Bill

CDCAN Report #141, Thursday June 30, 2011

GOVERNOR BROWN SIGNS MAIN BUDGET BILL – MAKES ONLY $23 MILLION IN LINE ITEM VETOES – KEEPS FUNDING FOR ADULT DAY HEALTH CARE

SACRAMENTO, CALIF (CDCAN)  [Last updated 06/30/2011  12:50 PM  ] -  Governor Jerry Brown signed SB 87, the main budget for the State’s 2011-2012 budget year that begins on Friday, July 1.   A full CDCAN Report on the Governor’s actions will be issued within the hour.  The Governor kept in the budget the funding restored by the Legislature for Adult Day Health Care but deleted a provision in the budget that requires a specified spending level for the program during the 2011-2012 State Budget year because “it does not consider other services available to these individuals [using Adult Day Health Care] that preserve their ability to remain in the community.” Read the rest of this entry »

UDW co-sponsored bill passes Senate, goes to Governor for signature

SB 930, introduced by State Sen. Noreen Evans (D-2nd District),  which would remove the fingerprinting requirements for IHSS recipients and providers,  passed the Senate on a 23-15 vote on September 1 and will be sent to Gov. Brown for signature.  He has 30 days to act on the bill.

Description: Would remove the fingerprinting requirement for IHSS recipients. Would remove the requirement to include spaces for provider and recipient fingerprints on provider timesheets. Would also remove the prohibitions against use of a post office box address by an IHSS provider.

Committee Analysis

2011 CA S 930: Bill Analysis – Assembly Human Services Committee – 06/28/2011

SUBJECT: In-home supportive services: enrollment and fingerprinting requirements

SUMMARY: Repeals requirements that In-Home Supportive Services (IHSS) recipients provide fingerprint images and that provider timesheets include spaces for provider and recipient fingerprints, and repeals the prohibition against providers using a post office box address to receive their paychecks.

 Specifically, this bill:

    1) Repeals the requirement that IHSS recipients provide fingerprint images at the time of assessment or reassessment.

    2) Repeals the requirement that the standardized timesheet include designated spaces for the index fingerprints of the provider and the recipient.

    3) Deletes the requirements and prohibitions related to the use of a post office box address by an IHSS provider.

 COMMENTS:

According to the author, this bill is intended to repeal three untenable components of the “IHSS Anti-Fraud Initiative” included in the 2009-10 budget trailer bill related to IHSS, AB X4 19, Chapter 17, Statutes of 2009 4th Extraordinary Session. The author says:

In 2009, Governor Schwarzenegger persuaded the Legislature to adopt the “IHSS Anti-Fraud Initiative.” The purpose of this effort was to ensure the identity of IHSS applicants and to prevent duplicate aid. The initiative included ten separate components. Three components of this initiative have proven to be costly and ineffective: (1) fingerprinting for all consumers, (2) provider and consumer fingerprints on timesheets, and (3) prohibition of the use of P.O. Boxes by providers on IHSS forms. There is no evidence to support the effectiveness of these three “anti-fraud” mandates. In the absence of this evidence, the $41.6 million to be spent on this part of the program should be spent on other priorities.

Background: In 2004, comprehensive legislation was enacted to standardize assessment of IHSS recipients’ needs and to ensure integrity in the IHSS program. SB 1104 (Committee on Budget & Fiscal Review), Chapter 224, Statutes of 2004. Among other requirements, SB 1104 directed DSS and the Department of Health Care Services (DHCS) to develop a new provider enrollment form that each person seeking to provide supportive services must complete, sign under penalty of perjury, and submit to the county. SB 1104 also gave DHCS authority to investigate suspected instances of fraud in the IHSS program. SB 1104 required DSS, DHCS, and county quality assurance staff to work together and coordinate activities.

In July 2009, AB X4 1 (Evans), Chapter 1, Statutes of 2009 4th Extraordinary Session, allocated additional 2009-10 and 2010-11 funds to DHCS and DSS for a total of 25 new fraud investigation and program integrity-related positions. AB X4 1 additionally included $10 million in additional funds to be allocated to counties based on their approved plans. AB X4 4 (Evans), Chapter 4 of the 2009-10 Fourth Extraordinary Session, the human services trailer bill, also included changes to provisions governing the new provider enrollment form, requiring documentation to be submitted in person by applicant providers to county offices.

At the same time, AB X4 19 (Evans), Chapter 17, Statutes of 2009 4th Extraordinary Session, was enacted to enhance program integrity and anti-fraud protections in the IHSS program. AB X4 19 was considered through the budget process and was not vetted through legislative policy committees. It included the following anti-fraud measures: (1) new provider enrollment requirements, (2) fingerprinting and criminal background checks for all providers, (3) increased data matching with jail, death and other official records to eliminate fraudulent claims, (4) provider acknowledgement of delivering services, (5) provider orientations, (6) unannounced home visits, (7) fraud training for county staff, (8) prohibition on the use of post office boxes by providers on IHSS forms, (9) fingerprinting recipients, and (10) fingerprints of recipient and provider on each timesheet. This bill repeals the last three of these measures.

    No cost-benefit analysis was done at the time to support the anti-fraud measures of AB X4 19, including the fingerprinting requirements. Nonetheless, the 2009-10 Budget included the Schwarzenegger Administration’s estimate of about $162 million General Fund savings as a result of new anti-fraud activities in the IHSS program. The estimated savings were based on an assumption of a basic 10% of program costs. No further empirical basis for the assumption was offered. The Administration’s 2010-11 Budget estimated an annual General Fund Savings of $130 million annually from anti-fraud measures.

How common is IHSS fraud? Statewide data on the incidence of fraud in the IHSS program is lacking. Federal participation in the cost of IHSS services comes through the Medicaid program, and because DHCS is California’s single state agency for Medicaid, the unit charged with investigating reports of suspected fraud in the IHSS program is located within that department. As reported in June 2009, according to DHCS:

Currently there is no accurate means of measuring or monitoring IHSS fraud within the state. This is because of the number of jurisdictions involved and the various data collection systems in place…

Because there is no accurate means of measuring or monitoring IHSS fraud within the state, we do not know the exact number of providers or recipients committing fraud.

In-Home Supportive Services: A Primer on Potential Fraud and Suggestions for Curbing It, California Senate Office of Oversight and Outcomes (June 26, 2009), p. 3.

While accurate statewide data on the incidence of IHSS fraud is lacking, there is no shortage of misinformation. For example, in support of the prior administration’s anti-fraud proposals, Governor Schwarzenegger and a number of district attorneys repeatedly referenced a figure of 25% in fraudulent IHSS payments. This figure appears to have originated in a 2004 Spring Finance Letter in reference, not to fraud but, rather, to weaknesses and deficiencies in the needs assessments conducted at the time. Based on State level case reviews conducted for a number of years, the Finance Letter notes, “at least 10% of all paid services may be over-assessed or have not actually been provided.” The Finance Letter then references the Governor’s Budget for FY 2004-05, which reportedly “acknowledged that up to 25% of the hours may be over-assessed.” This 25% figure was then picked up by news media and reported as a reflection of fraud in the IHSS program, rather than over-assessments due to problems with the need assessment process then in use.

A handful of grand jury reports issued during this period were likewise misrepresented. The Sacramento County grand jury released a report in March, 2009, for example, entitled IHSS: For the Needy, Not the Greedy. The report begins with statistics. From 2005-06 through 2006-07, Sacramento County paid $151 million to IHSS providers. Investigations found $820,000 in fraudulent overpayments. This represents 0.54% of payments. About 10% of these overpayments were recovered, according to the grand jury. Similarly, in fiscal year 2006-07, the grand jury found that there were 397 reports of suspected fraud out of approximately 17,735 IHSS cases-or 2.2%. Of those, 31 were referred and accepted for prosecution, a rate of prosecutable fraud of only 0.2%. Then, the grand jury report shifted away from data to sworn testimony. The report provides a list of fraudulent activities that at least one witness believed has taken place at least once within the county. The list is without quantification or details, and the report includes no direct quotations from witnesses’ statements.

Moreover, the grand jury did not assert that these activities went undetected, only that a witness said each activity had occurred. The grand jury concluded, offering no evidence in support and offering some evidence to the contrary, that fraud is “rampant and out of control.” The grand jury chose to highlight this broad and unsubstantiated claim in its executive summary and press release, and the media reported on it.

In sum, available data do not support the conclusion that there is widespread fraud in the IHSS program. If anything is rampant and out of control, it is the repeated dissemination of misinformation about the incidence of IHSS fraud.

Nonetheless, this bill does not impact most of the anti-fraud measures enacted through AB X4 19. It would cancel only the requirement that counties secure fingerprint images of applicants for and recipients of IHSS at the time of application or reapplication; the requirement that timesheets have a space for an index-finger print of both the recipient and the provider of IHSS; and, the prohibition against providers using a post office box for receipt of wage checks. In addition to “quality assurance” provisions added by the Legislature in 2004, seven of the ten measures included in AB X4 19 would remain in place.

Duplicate aid fraud: Fingerprinting of IHSS recipients is purportedly intended to prevent duplicate aid fraud-i.e., receiving aid under more than one identity or in more than one county. Whatever the overall incidence of fraud in the IHSS program, no data are available on the incidence of this type of fraud. In fact, it is difficult to even conceive of scenarios of how such duplicate aid fraud might be perpetrated by the seniors and people with disabilities who receive IHSS services.

As advocates opposing proposed 2010-11 Budget expenditures for proceeding with recipient fingerprinting pointedly remarked at the time, “[t]his is a solution in search of a problem; there is no evidence that people are disguising themselves as someone else to get IHSS, or that people are going from county to county to be bathed.”

Arguments in support: The California State Association of Counties (CSAC) and County Welfare Directors Association of California (CWDA) note in their joint support letter that the state has estimated that it would need $8.2 million this year alone, and a total of $41.6 million over the next 7 years, to implement the recipient fingerprinting requirement. “Clearly,” CSAC and CWDA say, “in these difficult fiscal times, the expenditure of millions to implement an anti-fraud initiative in the absence of demonstrated widespread fraud would be imprudent at best.” The Western Center on Law and Poverty quotes a May 8, 2010 letter to DSS from the Obama Administration concerning fingerprinting in the CalFresh program, which notes that “[m]ost States satisfy the requirement to establish a system to prevent duplicate participation by matching names with social security numbers, which is far less costly than finger image systems yet equally effective at detecting duplicate participation.”

Disability Rights California (DRC) notes, in relation to the prohibition on providers’ use of post office boxes, that there are many valid reasons that IHSS providers use post office boxes. Many IHSS providers live in rural areas where there are no alternative means for receiving mail. Also, many providers live with relatives or roommates who do not allow them to get mail sent to their residence. The U.S. Postal Service itself points out on its Web site that “[m]any customers value the privacy, security, and flexibility of a Post Office Box,” noting, for example, that: “It’s fast. Mail typically arrives faster at a PO Box than at a residential or business address” and “It’s permanent. You can move around, but your PO Box address stays the same.” CSAC and CWDA assert that limiting the use of post office boxes may harm the ability of counties and consumers to recruit and retain providers. In any event, as DRC points out, no evidence was ever offered to connect post office boxes with fraud.

Arguments in opposition: The California District Attorneys Association (CDAA) suggests that the anti-fraud measures in question, and particularly the fingerprinting requirements have a deterrent effect and that repealing these measures “will significantly hinder efforts to deter persons from seeking duplicate aid and could potentially make the discovery of such fraud more difficult.” CDAA also opposes repeal of the prohibition on using post office boxes, asserting that “[t]he less physical information law enforcement and prosecutors have about persons who would defraud the IHSS program, the harder it is to intercede and stop such activity.”

REGISTERED SUPPORT / OPPOSITION:

Support

American Civil Liberties Union American Federation of State, County and Municipal Employees (AFSCME) California Alliance for Retired Americans California Association of Public Authorities for IHSS (cosponsor) California Coalition for Women Prisoners (CCWP) California Disability Community Action Network California Foundation for Independent Living Centers California In-Home Supportive Services Consumer Alliance California State Association of Counties (CSAC) California United Homecare Workers Union, SEIU/AFSCME Local 4034 Californians for Disability Rights Communities United in Defense of Olmstead Contra Costa County County Welfare Directors Association of California (CWDA) Congress of California Seniors (CCS) Disability Rights California (cosponsor) In Home Supportive Services Coalition AARP-California Access to Independence ACLU Southern California California Alliance for Retired Americans California Association of Public Authorities California Church IMPACT Congress of California Seniors Californians for Disability Rights California Foundation for Independent Living California IHSS Consumer Alliance California Senior Legislature California Disability Community Action Network California United Homecare Workers Dayle McIntosh Center for the Disabled Disability Rights California East Bay Community Law Center Friends Committee on Legislation Gray Panthers Independent Livings Resource Center Inc. Marin IHSS Public Authority National Senior Citizen’s Law Center Nevada-Sierra-Plumas Public Authority Northern California ADAPT Older Women’s League Legal Services for Prisoners with Children National Association of Social Workers Pamela Hoye Personal Assistance Services Council of Los Angeles County San Francisco In-Home Supportive Services Public Authority Service Employees International Union (SEIU) California (cosponsor) State Independent Living Council The Arc and United Cerebral Palsy in California United Domestic Workers of America/ AFSCME Local 3930/ AFL-CIO (cosponsor) Western Center on Law & Poverty 1 Individual

Opposition

California District Attorneys Association (CDAA)

 Analysis Prepared by: Eric Gelber / HUM. S. / (916) 319-2089

What the New Budget Means for IHSS and UDW

So far this year, UDW–in partnership with our allies–has been able to prevent the worst of Gov. Brown’s proposed cuts in IHSS: A massive across-the-board reduction in IHSS service hours and the elimination of domestic and related services for most recipients.

Nevertheless, the cuts that were approved by the Legislature, including a 3.6 percent across-the-board cut from last year, continue to deeply affect providers and recipients. Read the rest of this entry »

CDCAN Report on state budget impact to social service programs

CDCAN DISABILITY RIGHTS REPORT 
#137-2011 – JUNE 28, 2011 – TUESDAY LATE EVENING

LEGISLATURE FINISHES WORK ON ALL BUDGET BILLS - MAIN BUDGET BILL SENT TO GOVERNOR

State Senate and Assembly  Pass on A Majority Vote 7 Budget Related Bills Including 3 Dealing With “Trigger Cuts” In January 2012 If $4 Billion in Additional Revenues Projected in Budget Plan Doesn’t Come Into State Treasury As Hoped For – “Trigger Cuts” If Pulled In January 2012 Would Impact IHSS, Developmental Services, K-12 Education, University of California and California State University systems; Program of All-Inclusive Care for the Elderly, AIDS Foundation and Senior Action Network Read the rest of this entry »

Update on State Budget

Governor Brown introduces new budget proposal

Gov. Jerry Brown and Democratic legislative leaders announced Monday that they reached an agreement on a majority-vote budget plan which will likely be voted on today or Wednesday.

The proposal is basically identical to the one the Governor vetoed earlier this month, except that it assumes that the state will bring in an additional $4 billion in revenues in the upcoming fiscal year, based in part on higher-than-expected revenue figures in recent months. If those revenues fail to materialize by January 2012, additional cuts to programs will be triggered, possibly including cuts to IHSS.

The governor, who has been working for months to secure Republican votes needed to hold a statewide election on expiring higher tax rates, told the Sacramento Bee that without a deal on his original proposal, leaders will have to “look very seriously” at using the initiative process to qualify a measure to secure future revenues. More detail, Sacramento Bee »

Governor Brown & Legislative Democratic Leaders reach budget agreement without Republican support – budget plan won’t contain tax extensions

CDCAN Report #133-2011,  Tuesday June 28

Higher Revenue Projections and Additional Cuts to Higher Education Will Close Budget Gap  in Democratic Plan – “Trigger” In Budget Plan Would Be Pulled If Revenues Don’t Come in As Planned By Next January That Could Impact Health and Human Services, Education and other Budget Areas – Vote on Budget Could Happen As Early As Tuesday or Wednesday – Governor’s Position on Adult Day Health Care Not Clear Yet

SACRAMENTO, CALIF (CDCAN)  [Last updated 06/28/2011  3:50 AM] -  Giving up on winning support from Legislative Republicans, Governor Jerry Brown reached an agreement late Monday afternoon with the Legislature’s two Democratic leaders, Senate President Pro Tem Darrell Steinberg (Democrat – Sacramento) and Assembly Speaker John Perez (Democrat – Los Angeles) with a budget plan that will not contain his proposals to extend for five years the 2009 temporary tax increases scheduled to expire June 30, 2011 but instead counts on $4 billion more in revenues that he hopes California will bring in next year.  The agreement will mean that there will be no special election in 2011 and that any proposal to increase taxes for voters to decide will be placed on the November 2012 general election ballot by petition rather than by a 2/3rds vote of the Legislature that would require at least 2 Republican votes in the State Senate and the Assembly (assuming all Democrats voted for it). Read the rest of this entry »

Rev. Al Sharpton and AFSCME’s Lee Saunders Urge San Diegans to Stand Up and Fight for Working Families and Public Services

At a leadership breakfast and town hall meeting organized by UDW, noted civil rights leader Rev. Al Sharpton and AFSCME International Secretary Treasurer Lee Saunders urged labor, religious and community leaders to fight back against efforts to cripple public services and weaken working families.

Sharpton and Saunders are traveling across the country to fight against the coordinated attack on public employees and the services they provide. They stopped in San Diego to rally community support to oppose a number of ballot initiatives that would significantly weaken the rights and benefits for the city’s public employees.  Read the rest of this entry »

The Conversation: The fingerprint fraud

By Foon Rhee  Sacramento Bee  Published: Sunday, Jun. 26, 2011 – 12:00 am | Page 1E

From the very start, the sales pitch promised too much.

Flanked by prosecutors, then-Gov. Arnold Schwarzenegger declared that fraud was rampant in California’s home health program for low-income elderly and disabled – and that requiring caregivers and clients to put their fingerprints on time sheets would help stop the abuse.

I’m all for rooting out whatever cheating there is in the In-Home Supportive Services program, particularly in these tough budget times. But the fingerprint fetish isn’t how to do it; by now, it’s clear that the prints would be of such poor quality that they would be useless.  ..Read Editorial, and comment on forum »

San Diego & Orange Counties: UDW networks with Asain community

 

UDW President Laura Reyes and Secretary Treasurer Lien-tuong Rose Nguyen along with  E-Board members from Orange & San Diego Counties Networked with the San Diego Asian Youth Organization

Taken @ the San Diego Asian Youth Organization Fundraiser dinner on 5/13/11..

Read the rest of this entry »

Opinion: Budget must not abandon Californians trying to escape poverty

By Stella Kim and Judy Patrick, Special to the San Jose Mercury News

Now that Gov. Jerry Brown has vetoed the Democrats' budget, things are even more desperate. While we commend him for pushing back against gimmicks, unless we get agreement on how to increase revenues, we will be looking at an all-cuts budget. Californians simply cannot afford that.

People like Michele Marino will already be paying a high price when we enact the cuts that have been made. A Cal State Long Beach student, Michele is determined to get an education and make a better life for her two sons. Fed up with her abusive partner, Michele decided to leave even though her low-wage job didn't provide enough income. She sought help and began participating in CalWORKS, our state's welfare-to-work program. Now, she also helps other women who want to leave abusive relationships.

Unfortunately, recent cuts to CalWORKS jeopardize Michele's dreams. Instead of receiving $533 per month, Michele would get just $492. That's $42 dollars less, which may not seem like much. But that $42 helps Michele get food on the table and pay for gas that allows her to drop her kids off at school, drive to class and ultimately get off CalWORKS.  Read Article »

Legislators will not get paid until budget is passed

CDCAN Report #132-2011

 

STATE CONTROLLER CHIANG: WILL NOT PAY LEGISLATORS UNTIL BUDGET IS PASSED

Chiang Says June 15th Budget Approved by Legislature But Vetoed by Governor Brown Was “Incomplete and Unbalanced”

State Controller's Budget Analysis Sheet

 

SACRAMENTO, CALIF  (CDCAN)  [Last Updated 06/21/211 11:59 AM] -  State Controller John Chiang today announced today that he will not issue paychecks or reimbursements for travel and living expenses to members of the California Legislature because the Legislature failed to pass a State Budget by the June 15th State constitutional deadline.  Each member of the Legislature will permanently forfeit their pay, travel and living expenses from June 16th and each day that follows until a budget – presumably one that meets the standard of the State Controller being “complete and balanced” is passed by the Legislature and sent to the Governor.  They will not receive that lost pay back even when a budget plan is finally passed.  Read the rest of this entry »

Update on Lawsuits Impacting IHSS

Following is a summary of recent litigation with great potential to impact IHSS providers. For greater detail or to find out about other IHSS-related litigation
Click Here  

 

Dominguez et al. v. Schwarzenegger et al.

Background:

The IHSS program is funded by a combination of federal, state, and county money. The Federal share is 50%, the state share is 32.5% and the county share is 17.5%. State participation in wages and benefits is governed by Welfare and Institutions Code (WIC) Section 12306.1. Currently, the state will pay up to $12.10 per hour per provider ($11.50 in wages and $0.60 for benefits, per hour). However, each county, through the collective bargaining process, determines how much the actual wages and benefits will be.

 

Summary:

In February 2009, the Legislature and Governor Schwarzenegger passed legislation to cut state participation in IHSS provider wages from $12.10 per hour ($11.50 in wages and $0.60 for benefits, per hour) to $10.10 per hour ($9.50 in wages and $0.60 in benefits, per hour) effective July 1, 2009.  Many IHSS providers, consumers, and advocates were concerned that this would force IHSS workers in some counties to quit their work to find better paying jobs, leaving their consumer without a provider, and therefore placing the consumer at risk of unnecessary institutionalized. A lawsuit was filed by Martinez et al. (“et al.” means “and others” – in this case these were IHSS consumers and unions) against the State for violating the Americans with Disabilities Act, the Rehabilitation Act, and the procedural requirements of the Medicaid Act. This lawsuit was later renamed Dominguez et al. v. Schwarzenegger et al.

 

STATUS

On May 26th, 2009 the Dominguez et al v. Schwarzenegger lawsuit was filed to prevent the state from cutting state participation in the provider wage rate by two dollars per hour. In July 2009, a federal court issued an injunction that prevented the State from reducing state participation in IHSS provider wages and health benefits without first conducting an analysis of the effect such a reduction would have on quality of and access to IHSS services. The Court also found that IHSS consumers “will suffer immediate and irreparable harm” as a result of the wage reductions. The State appealed this court decision; however the injunction was reaffirmed in March 2010. The State since filed to have the decision reviewed by the U.S. Supreme Court. The lawsuit, in conjunction with others, will be heard on a 15-day bench trial starting on December 5th, 2011.

Potential Impact for UDW:

Over 15 counties in California pay IHSS provider wages and benefits over $10.10 per hour (over $9.50 in wages and/or over $0.60 in benefits). Four of these are UDW-represented counties: Placer, Riverside, San Luis Obispo, Santa Barbara counties.  If the outcome of the lawsuit is in favor of the State, each of these counties will be 50% responsible to fund the difference between what they pay and the new maximum of $10.10 per hour (federal participation of 50% would continue until $16/hour). These counties would not get reimbursed by the state. This would be retroactive to July 1, 2009. This would create a huge financial burden for these counties, and would lower the ceiling on provider wages in every county in the state.



 

Oster et al. v. Wagner

Background:

During the IHSS assessment process, a county social worker “ranks” the consumer on a scale of 1 to 5 in a range of possible categories, such as domestic services, related services such as meal preparation, non-medical personal services such as bathing, and paramedical services such as insulin injections. Each rank number is supposed to correspond with the level of need of assistance in that category. Being given a rank of 1, for example, means the consumer does not need assistance in that task, whereas a 5 means they completely depend on assistance in that category. Each consumer is also assessed a Functional Index (FI) Score, which is a weighted average of all functional index rankings in all categories assessed to the consumer. In theory, FI ranks and scores are supposed to reflect the consumer’s level of need of in-home care. However, this ranking system sometimes does not truly reflect the needs of many IHSS consumers, including those with mental and developmental disabilities.

 

Summary:

In July 2009, the Legislature and Governor Schwarzenegger passed legislation that eliminated IHSS services for consumers with Functional Index (FI) Scores below 2.0. It also cut IHSS domestic and related services for consumers with FI Scores below 4. These changes were supposed to take effect on November 1st, 2009. However, a lawsuit (originally named V.L. et al. v. Wagner) was filed, arguing that these changes in eligibility would place consumers at risk of harm to their health and safety, and at risk of unnecessary institutionalization, a violation of the federal Americans with Disabilities Act. According to the lawsuit, the decision to limit IHSS services also violates the federal Medicaid Maintenance of Effort and violates the due process constitutional guarantee. This lawsuit was later renamed Oster et al. v. Wagner.

 

STATUS

On October 1st, 2009, the original lawsuit was filed to prevent enactment of the changes in eligibility related to FI scores. Later that month, a federal court judge issued a preliminary injunction ordering the State to stop implementation of the new law. The State appealed the decision and currently the case has been set aside until several lawsuits that are now in the U.S. Supreme Court are decided, or until further order of the court.

Potential Impact for UDW:

At the time of the lawsuit in 2009, it was estimated that about 40,000 consumers across the State had FI Scores lower than 2.0, and thus would lose all services. Also, 97,000 consumers would lose their domestic and related services, or 30% of their total IHSS service hours. If the State is successful in this lawsuit and proceeds to implement the law a large percentage of the IHSS consumer population would lose some or all of their IHSS services.

 



 

Beckwith v. Wagner

Background:

In July 2009, legislation was passed by the Legislature and Governor Schwarzenegger that, among other things, created a new criminal background check requirement for existing and new IHSS providers. Existing law considered providers not eligible to provide care if they had convictions of or incarceration within the last 10 years following conviction of three crimes: fraud against a government or supportive services program, child abuse, or elder abuse. These are currently called “Tier 1” crimes.

 

Summary:

The California Department of Social Services (CDSS) sent letters to counties stating that any individual convicted of any felony at any time is disqualified from being an IHSS provider. This superseded existing law, which only noted conviction of the three specified crimes (above) within the last 10 years. A lawsuit was filed against the State to prevent the CDSS from unilaterally disqualifying IHSS providers who were otherwise qualified under the law to get paid through the IHSS program to provide care.

 

STATUS

Originally named Ellis v. Wagner, a lawsuit was filed against the State to rescind the new policy. The lawsuit was later renamed Beckwith v. Wagner. In February 2009, a Superior Court judge ordered CDSS to not use the new enrollment forms, to not disqualify providers for extraneous crimes and time spans, and to inform the providers who had been wrongfully disqualified that they can re-apply. Following a series of appeals, this decision was made final on May 31, 2011.

 


 

How you can help PROTECT IHSS — send this message to the Governor

Tell Governor Brown "No More Cuts to IHSS"

Here's how:
It's easy - USE THIS LINK to connect with our automatic fax.  You don't need a fax machine; we have a letter you can personalize and it will not cost you anything.

Here's why...
As you may know, Governor Brown vetoed the state budget last week.

We are very disappointed with the Governor’s veto. Though it was not ideal, this budget made serious progress toward solving our state’s deficit problem.  It also included some innovative proposals to prevent further cuts to the IHSS program. It was a great improvement from where we were just a few short months ago.

That is why we would like you to FAX THE FOLLOWING LETTER to the Governor.  Tell him you are disappointed in his veto.  Tell him that IHSS providers and recipients have already suffered as a result of budget cuts and will not stand for any more.

Sending the fax will not cost you anything. Just click the above link and you can follow a couple of easy steps to have it sent in your name, automatically.

We will keep you informed of any new developments.

 

# # # 
 

Can you help to spread the word on this?
CLICK HERE to get involved

HHS Network hosts state budget briefing Thursday, June 23

Hosted by Health & Human Services Network of California

Statewide Briefing Call Thursday, June 23, 3:00 PM
Toll Free call-in: 866-516-5393 Pass Code: 78010970 

IHSS Providers & Consumers; Join the HHS Network to get informed on how the state budget will impact social programs including IHSS.  Read the rest of this entry »

Riverside: ADDUS contract renewed in competitive bid process

Addus Home Care Awarded Contract Renewal in Riverside County, California

Red Orbit News   Posted on: Thursday, 16 June 2011, 07:30 CDT

PALATINE, Ill., June 16, 2011 /PRNewswire/ — Addus HomeCare Corporation (Nasdaq: ADUS), a comprehensive provider of home-based social and medical services, announced today that it was awarded a contract renewal to be the agency provider of home-based personal care through Riverside County's In-Home Supportive Services (IHSS) program.

Addus was the successful bidder in a competitive bidding process for the contract, which will be funded through a combination of state, federal and county sources. The contract runs from July 1, 2011 to June 30, 2012, with two additional option years. Valued at $11.5 million annually, the award represents Addus' largest sole-sourced contract. Addus is a full-service provider in Riverside County, with personal care, home health, commercial and private care. Read the rest of this entry »

UDW update on State Budget, Thursday June 16

 

Current Status of the Budget
 
On Wednesday, June 15th the Senate and Assembly passed by majority vote the main budget bill – AB 98.  Both houses lacked the 2/3rds majority vote necessary to approve Governor Brown’s revenue proposals, which would have resulted in $10.8 billion in new revenue.
 
On June 16, 2011 Governor Brown vetoed AB 98 and SB 69 – the two budget bills approved by the Legislature (AB 98 was approved on June 16th and SB 69 was approved in March). The Governor’s explanation for his veto is that the budget is unbalanced, contains too much borrowing, and does not contain the revenue extensions he proposed in January.
 
The final budget package contains $12.5 billion in spending cuts that were adopted in the spring. These included $5 billion in cuts to health and human services programs, including nearly $500 million to the In-Home Supportive Services program. Due to a lack of the 2/3rds vote necessary to approve the Governor’s proposed tax extensions, the budget package also contained $10.3 billion in additional actions, such as one-time federal funding, restoration of local sales tax rates, and deferment of Proposition 98 spending. These actions, in conjunction with increased revenue estimates and other offsets, addressed the unprecedented state budget deficit of $27.6 billion.
 
Senate President Pro Tem Steinberg and Assembly Speaker Perez held a press conference the morning of June 16th to express their serious displeasure with the Governor’s veto. They stated that Democrats in the Legislature have worked diligently for the last six months to assist the Governor in implementing his proposed budget. However, this proposal was rejected by Republican legislators time and time again. In light of the June 15th deadline to pass a budget, Legislative leaders were compelled to move forward with “Plan B” – a budget deal that could be approved on time with a majority vote. Though it did not include the billions of dollars of revenue sought by the Governor, the budget eliminates over 60% of the state’s persistent structural deficit. According to Senator Steinberg, “the Governor is …. a little bit confused between total victory, which in this process cannot be achieved in one year, and progress.”
 
The alternative to the current budget deal is unclear. According to Senator Steinberg and Speaker Perez, there is no Democratic support for further cuts to programs and services. If the Governor chooses to pursue further spending cuts, they would not assist him in garnering Republican support.
 
The Budget Package Approved by Assembly and Senate Legislators on June 15, 2011
 
AB 98 enacted a combination of further reductions, one-time shifts, deferrals, and other measures to make up for the remaining budget deficit.
 
Major components of the budget package include:
 
  • $700 million in one-time federal funding for the Medi-Cal program
  • $300 million additional reduction to University of California and California State University systems
  • $2.85 billion deferral in K-15 Proposition 98 spending
  • Reduction and redirection of local Proposition 10 funding to children’s Medi-Cal services ($1 billion savings)
  • Ends “revenue exchange period” resulting in ¼ percent increase in local sales and use taxes ($900 million savings)
  • Revised state building lease transaction ($1.2 billion new revenue)
  • Updated revenue estimates since the May Revision ($815 million)
 
By the Legislature’s own account, these budget solutions will only partially address California’s long-term structural budget problems. This means that we can expect to see more budget deficits in the near future.
 
The Senate and Assembly also passed a series of budget trailer bills which essentially implement the provisions of the main budget bill. These bills are additions to the budget trailer bills passed by the Legislature and signed into law by the Governor in March.
 
AB 106, the human services budget trailer bill which included changes to IHSS was among the budget trailer bills that were adopted. Importantly, the bill did not include any major changes to the IHSS program.
 
Next Steps
 
At this time, UDW is in conversation with allies about next steps. We will keep you posted as the situation develops
 
Governor’s Proposal (January 2011)
 
Governor Jerry Brown submitted his budget to the state legislature on January 10, 2011. Faced with an unprecedented deficit of $26.6 billion, the Governor proposed approximately $12.5 billion in spending cuts, approximately $12 billion in increased revenues and approximately $1.1 billion as a reserve. The spending cuts included a $486.2 million reduction to the In-Home Supportive Services (IHSS) program. This reduction was achieved by a combination of across the board cuts ($127.5 million), the elimination of domestic and related services for most recipients ($236.6 million), the elimination of services for those without a physician’s certification ($120.5 million), and the elimination of state funding for IHSS Advisory Committees ($1.6 million).
 
The Governor also proposed an expedited 60-day timeline for the Legislature to approve his budget proposals. This was done in order to hold a special election on his revenue proposals in June.
 
Legislative Actions (February and March 2011)
 
Assembly and Senate budget subcommittees began meeting to discuss the Governor’s budget on January 27th. Ultimately, both houses voted to reject the majority of the Governor’s proposed cuts to IHSS, though the savings target of $486.2 million remained. On March 17th, the legislature passed budget legislation that included the following provisions related to IHSS:
 
  • A requirement that all recipients obtain certification from a licensed health care professional that without IHSS services the recipient is at risk of being placed in institutional care (estimated savings of $120 million).
  • A mandate for the state’s participation in the new Community First Choice Option available under Federal law as of October 1, 2011 (estimated savings of $128 million).
  • The elimination of the mandate and most of state funding for IHSS Advisory Committees (estimated savings of $1.4 million).
  • A mandate for the implementation of the Medication Dispensing Pilot Project beginning July 1, 2011. The goal of the pilot is to reduce hospitalization and institutionalization resulting from medication noncompliance among high-risk Medicaid recipients. There is a stipulation that should the requisite savings not be achieved by July 1, 2012, there will be a mandatory across the board reduction in service hours for all IHSS recipients (estimated savings of $140 million).
 

 

Governor Brown vetoes state budget bill – says he does so “reluctantly, but with clear purpose”

 CDCAN Report #130-2011  Thursday June 15, 2011

 

Legislature Will Have To Resume Efforts To Hammer Out A New Budget Deal That Meets Governor’s Concerns

 

SACRAMENTO, CALIF  (CDCAN)  [Last Updated 06/16/2011  11:19 AM] -  Governor Brown, saying he was doing so “reluctantly but with clear purpose”, vetoed SB 69 and AB 98 that comprise – together – the 2011-2012 main budget bill approved yesterday on a majority vote by the Legislature controlled by the Democrats. Read the rest of this entry »

Legislature sends majority vote budget bills to governor by deadline

CDCAN Report #127-2011, Wednesday June 15th 2011

 

Both Houses Complete Work on 2011-2012 State Budget – Budget Plan Does Not Contain Extensions of 2009 Temporary Tax Increases – No New Additional Cuts Beyond What Was Approved in Late May and March to Health & Human Services – But On-Going Budget Deficit of Nearly $7 Billion Remains To Be Solved in 2012

 

SACRAMENTO, CALIF  (CDCAN)  [Last Updated 06/15/2011  04:20 PM] -  The California Legislature passed and sent to Governor Brown a package of bills making up the 2011-2012 State Budget passed on a majority vote without help from legislative Republicans, by the June 15th State constitutional deadline that avoided the “all cuts budget” scenario and left unresolved for now, an ongoing budget deficit next year of nearly $7 billion.  Read the rest of this entry »

State Senate passes revised main budget bill on majority vote without Republicans

CDCAN Report #126-2011, Wednesday June 15th 2011

 

No Extensions of 2009 Temporary Tax Increases In Budget Package – Heads To Assembly For Final Action Today – Assembly Democrats Will Also Pass Budget Plan On Majority Vote

 

SACRAMENTO, CALIF  (CDCAN)  [Last Updated 06/15/2011  01:18 PM] -  The State Senate, which convened at 10:00 this morning, passed on a majority vote, the revised main budget bill that does not extend the 2009 temporary tax increases, but instead relies on other one-time accounting measures, fund shifts, some additional reductions impacting higher education and redevelopment agencies (but not to K-12 education or to health and human services).  The package also included increases in sales tax, vehicle registration fee and what is referred to as the “Amazon.com” tax that were done in such a way as to avoid the State constitutional requirement of a 2/3rds vote approval – and instead were passed by a simple majority vote.  Read the rest of this entry »

UDW Executive Director Doug Moore participates in ceremony marking the induction of the 1968 Memphis Sanitation Workers into the Labor Hall of Fame

 

"Ordinary workers took extraordinary stand, made history"


UDW's Executive Director Doug Moore (top row, right) with
1968 Memphis Sanitation Workers, June 4 2011  See more photos. 

 

Memphis sanitation strike was an important turning point in the fight for civil rights and workplace equality.

Guest Column, by U.S. Secretary of Labor Hilda Solis, The Memphis Tenessee Commercial Appeal

On Saturday, in the historic American city where one of the world's civil rights legends waged his final campaign for justice, the local sanitation workers who marched at his side will be remembered for changing America.

The labor dispute that brought Dr. Martin Luther King Jr. to Memphis 43 years ago was officially about union recognition, livable wages, overtime pay, grievance procedures and race-neutral promotions and pensions.

But the iconic signs carried by the sanitation workers in 1968 –"I Am a Man"– spoke to an even more fundamental aspiration of African-American workers that was realized within these city limits: the yearning for respect.  Read full Op-Ed describing this event

 

Watch the induction part of the ceremony at:  http://www.dol.gov/dol/media/webcast/20110604-memphis/
 
Read Secretary Solis’s full remarks from the ceremony at:  http://www.dol.gov/_sec/media/speeches/20110604_LHOF.htm
  

Final Vote on 2011-2012 State Budget Expected Wednesday — the constitutional deadline

 

CDCAN Report  #125-2011, Tuesday June 14, 2011

Legislative Democrats Ready To Pass Majority Vote Budget Without Help From Republicans – Budget Plan Would Not Have Tax Extensions But Rely On Fund Shifts, One Time Solutions In Addition To Cuts Already Passed In March and Approved by Budget Subcommittees In May 

 

SACRAMENTO, CALIF  (CDCAN)  [Last Updated 06/14/2011  04:40 PM] -  Barring a last minute surprise, both the State Senate and Assembly will convene floor sessions Wednesday (June 15th)  for a final vote on the 2011-2012 State Budget, with Legislative Democrats now ready to pass a spending plan on a simple majority vote without the tax extensions – but with fund shifts one time solutions in addition to the spending cuts previously passed in March and late May.   Read the rest of this entry »

VA to Take Applications for New Family Caregiver Program

Department of Veteran Affairs
FOR IMMEDIATE RELEASE
May 3, 2011
Office of Public Affairs, Media Relations
Washington DC, 20420
(202) 461-7800 
www.va.gov
 

NEWS RELEASE

VA to Take Applications for New Family Caregiver Program
VA Implementing Enhancements to Existing Services
for Veterans and Their Caregivers

WASHINGTON – Today, the Department of Veterans Affairs (VA) published the interim final rule for implementing the Family Caregiver Program of the Caregivers and Veterans Omnibus Health Services Act 2010. This new rule will provide additional support to eligible post-9/11 Veterans who elect to receive their care in a home setting from a primary Family Caregiver.

“We at VA know that every day is a challenge for our most seriously injured Veterans and their Family Caregivers,” said VA Secretary Eric K. Shinseki.   “I know many Veterans and their Family Caregivers have been waiting anxiously for this day and I urge them to get their applications in as soon as possible so they can receive the additional support they have earned.” 

On May 9, staff in VA’s Office of Care Management and Social Work will open the application process for eligible post-9/11 Veterans and Servicemembers to designate their Family Caregivers.

Additional services for primary Family Caregivers of eligible post-9/11 Veterans and Servicemembers include a stipend, mental health services, and access to health care insurance, if they are not already entitled to care or services under a health care plan. Comprehensive Caregiver training and medical support are other key components of this program. The program builds on the foundation of Caregiver support now provided at VA and reflects what families and clinicians have long known; that Family Caregivers in a home environment can enhance the health and well-being of Veterans under VA care.   

Starting May 9th, Veterans may download a copy of the Family Caregiver program application (VA CG 10-10) at www.caregiver.va.gov.  The application enables the Veteran to designate a primary Family Caregiver and secondary Family Caregivers if needed.  Caregiver Support Coordinators are stationed at every VA medical center and via phone at 1-877-222 VETS (8387) to assist Veterans and their Family Caregivers with the application process

“Providing support to Family Caregivers who sacrifice so much to allow Veterans to remain at home surrounded by their loved ones, is very important to us at VA.  We offer a range of Caregiver support services including training, counseling and respite care to ensure that our caregivers have the tools and support they need to continue in their care giving role,” said Deborah Amdur, VA’s Chief Consultant for Care Management and Social Work.  “We appreciate the patience, support and assistance we have received from Veterans, Veterans Service Organizations, and the greater Caregiver community in shaping this program and bringing this new VA program to our wounded warriors and their dedicated Family Caregivers.”

Caregivers for Veterans of all eras are eligible for respite care, education and training on what it means to be a caregiver, how to best meet the Veteran’s care needs, and the importance of self-care when in a care giving role. The full range of VA services already provided to Caregivers will continue, and local Caregiver Support Coordinators at each VA medical center are available to assist Family Caregivers in identifying benefits and services they may be eligible for.  The Caregiver Support Coordinators are well versed in VA programs and also have information about other local public, private and non-profit agency support services that are available to support Veterans and their Family Caregivers at home.      

VA programs for Veterans and their Family Caregivers include:

 

o    In-Home and Community Based Care:  This includes skilled home health care, homemaker home health aide services, community adult day health care and Home Based Primary Care.  

o    Respite Care:  Designed to relieve the Family Caregiver from the constant challenge of caring for a chronically ill or disabled Veteran at home, respite services can include in-home care, a short stay in one of VA’s community living centers or an environment designed for adult day health care. 

o    Caregiver education and training programs:  VA currently provides multiple training opportunities which include pre-discharge care instruction and specialized caregiver programs in multiple severe traumas such as Traumatic Brain Injury (TBI), Spinal Cord Injury/Disorders, and Blind Rehabilitation.  VA has a Family Caregiver assistance healthy living center on My HealtheVet, www.myhealth.va.gov, as well as caregiver information on the VA’s main Web page health site; both Websites include information on VA and community resources and Caregiver health and wellness.

o    Caregiver support groups and other services:  Family Caregiver support groups, offered in a face to face setting or on the telephone, provide emotional and peer support, and information.  Family Caregiver services include family counseling, spiritual and pastoral care, family leisure and recreational activities and temporary lodging in Fisher Houses. 

o    Other services:   VA provides durable medical equipment and prosthetic and sensory aides to improve function, financial assistance with home modification to improve access and mobility, and transportation assistance for some Veterans to and from medical appointments.  

 

# # #

State Budget Update, Saturday June 11

 

Sacramento — The Senate met Saturday morning for less than an hour. There was no action on any budget revenue items.

 

The Senate approved three bills: Read the rest of this entry »

Federal Lawsuit Filed to Stop Adult Day Health Care Closures

CDCAN Report #123-2011, Saturday June 11, 2011

 

FEDERAL LAWSUIT FILED TO STOP STATE FROM ELIMINATING ADULT DAY HEALTH CARE FOR OVER 34,000 PEOPLE WITH DISABLITIES & SENIORS

·        Lawsuit Claims State Is Violating Federal Law and Previous Federal Court Decisions Unless State Can Prove Elimination Will Not Cause Harm to Recipients

·        State Says Elimination Is Necessary Due to Budget Crisis and That It Is Moving To Transition People Safely Into Other Medi-Cal Services Read the rest of this entry »